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State of Florida Vs Aetna et alFrom: acf (evsono@pipeline.com)Fri Oct 27 07:37:45 2000
This in today's Reuters - New HMO probe revealed as panel moves to consolidate lawsuits in Miami Last Updated: 2000-10-26 18:01:28 EDT (Reuters Health) By Karen Pallarito NEW YORK (Reuters Health) - Florida's attorney general is investigating two of the nation's largest HMOs to determine whether the plans illegally denied or limited medical care. Attorney General Bob Butterworth has subpoenaed Hartford, Connecticut-based Aetna Inc. and Louisville, Kentucky-based Humana Inc. as part of a broad-based investigation, his office confirmed. The probe is being conducted under state racketeering laws, known as RICO. Assistant Attorney General Keith P. Vanden Dooren told Reuters Health that the state is looking into the HMOs' claims processing practices "to determine how they might deny or reduce claims or...not authorize medical treatment." The probe was prompted by a combination of complaints filed with the state Department of Insurance, interviews with witnesses, documents and media reports, he said. Florida's investigation was revealed in a memo filed with the Judicial Panel on Multidistrict Litigation, a federal panel that rules on jurisdictional issues in complex matters of litigation. That panel ruled on Monday that several major class-action lawsuits filed against the nation's largest HMOs should be consolidated in federal court in Miami. Judge Federico J. Moreno of the US District Court for the Southern District of Florida now presides over the cases, which target Aetna and Humana as well as Cigna Corporation, Foundation Health Systems, PacifiCare Health Systems, Prudential HealthCare and United Healthcare. As many as 20 managed care lawsuits filed across the country may be consolidated. "Already today there was a hearing on some of the motions that some of the defendants have made to dismiss the cases as improper cases under the law," said Stephen Neuwirth of Boies, Schiller & Flexner, one of the plaintiffs' attorneys. Moreno is expected to rule in November or December on whether the cases may proceed as a class action, Neuwirth said. The cases revolve around the alleged failure of some of the nation's largest HMOs to disclose financial incentives to deny or limit medical care services. Last October, Humana became the first national HMO to be named in a federal class-action, which seeks millions in damages. The legal strategy has been repeated numerous times across the country, including a batch of lawsuits filed against six large national companies this summer (see Reuters Health report, June 27). Neuwirth is among a group of plaintiffs' attorneys that maintained the cases should be consolidated in Miami. "We think it's very important because it will permit us to promptly develop the relevant facts that apply to all the relevant companies and prevent companies from playing one forum against the other," he told Reuters Health. He added that Attorney General Butterworth's ongoing investigation of Aetna and Humana is relevant to the larger case against the managed care industry, "because it confirms that there are serious issues relating to the conduct of these companies." But Brian Boyle of O'Melveny & Myers in Washington, DC, who represents Humana, blasted the consolidation effort as a "multi-defendant assault on the managed care industry." Humana argued in court that pending subscriber and provider suits against the company should be dismissed. Florida launched its investigation of Humana on October 25, 1999. The probe of Aetna began May 1, 2000. Aetna's attorney was in Miami and unavailable at deadline. A Humana spokeswoman said that the company does not comment on ongoing investigations. While the state is focusing on Aetna and Humana, the probe "may or may not get expanded out," Vanden Dooren said, and added, it may be a year or two before the investigation is completed. -New York Newsroom 212 603 3200 what took 'em so long? art
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